Trigeminal Neuralgia—A Comparative Analysis of Radiofrequency Electrode Lesioning Temperature at 65°C and 75°C for 60 Seconds Each

Asheesh Tandon; Mabel Banson; Chudasama Bhaumik; Himanshu Verma; Prashant Kushwaha; Alok Agrawal

doi:10.1055/s-0045-1809874

Indian Journal of Neurosurgery, Inhaltsverzeichnis

CC BY 4.0 · Indian Journal of Neurosurgery
DOI: 10.1055/s-0045-1809874

Original Article

Trigeminal Neuralgia—A Comparative Analysis of Radiofrequency Electrode Lesioning Temperature at 65°C and 75°C for 60 Seconds Each

Authors

Asheesh Tandon

¹Advance Neurosurgery Centre for Minimally Invasive Brain and Spine Surgery, Aditya Superspeciality Hospital and Trauma Centre, Jabalpur, Madhya Pradesh, India
Mabel Banson

¹Advance Neurosurgery Centre for Minimally Invasive Brain and Spine Surgery, Aditya Superspeciality Hospital and Trauma Centre, Jabalpur, Madhya Pradesh, India
Chudasama Bhaumik

²Department of Neurosurgery, Shri M. P. Shah Government Medical College, Jamnagar, Gujarat, India
Himanshu Verma

¹Advance Neurosurgery Centre for Minimally Invasive Brain and Spine Surgery, Aditya Superspeciality Hospital and Trauma Centre, Jabalpur, Madhya Pradesh, India
Prashant Kushwaha

¹Advance Neurosurgery Centre for Minimally Invasive Brain and Spine Surgery, Aditya Superspeciality Hospital and Trauma Centre, Jabalpur, Madhya Pradesh, India
Alok Agrawal

¹Advance Neurosurgery Centre for Minimally Invasive Brain and Spine Surgery, Aditya Superspeciality Hospital and Trauma Centre, Jabalpur, Madhya Pradesh, India

Abstract

Background

Pain affecting the distribution of one or more of the three divisions of the trigeminal nerve defines trigeminal neuralgia (TN). Radiofrequency ablation (RFA) is one of its effective treatment modalities. The ideal RFA lesioning temperature is still under evaluation.

Objective

The authors evaluate the efficacy of pain relief of RFA at 65 and 75°C, in patients with TN. Pain relief at 1 year was the study's primary outcome. Secondary outcomes: trigeminal division, complication rate, and recurrence rate.

Materials and Methods

Medical records of patients with refractory TN at our center were reviewed from January 2016 to December 2023; last new case in May 2023. Excluded were the patients who were lost to follow-up or had incomplete data. Data extracted include age, gender, lesioning temperature, and the extent of pain relief. Pain relief was recorded on a visual analogue scale of 0 to 100. Recurrence was defined as the need for repeat RFA. The data were entered and analyzed with IBM SPSS Statistics (version 26).

Results

Fifty-six patients were reviewed. The mean age was 59.6 ± 11.9 years; slight female preponderance. The commonest side of TN was the right (n = 35, 62.5%). Maxillary division (V2) was the most reported (53, 94.6%); isolated in 28 (50.0%) patients. Good-to-excellent pain relief at 1 year noted in 47 (83.9%) patients. Recurrence was 16.1%. The overall complication rate was 37.5%, commonest reported was numbness. Patients receiving the 75°C RFA had better pain relief; about 60% (n = 19) patients achieved excellent pain relief.

Conclusion

Better pain relief was observed with 75°C RFA, compared to the 65°C RFA. However, complications were higher with the 75°C RFA.

Keywords

trigeminal neuralgia - radiofrequency ablation - pain relief

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Referenzen

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